{"id":4798,"date":"2019-09-15T16:49:17","date_gmt":"2019-09-15T16:49:17","guid":{"rendered":"https:\/\/www.quinessence.com\/blog\/?p=4798"},"modified":"2020-05-30T09:58:46","modified_gmt":"2020-05-30T09:58:46","slug":"a-change-of-heart-research-reveals-new-ways-to-prevent-cardiovascular-issues","status":"publish","type":"post","link":"https:\/\/www.quinessence.com\/blog\/a-change-of-heart-research-reveals-new-ways-to-prevent-cardiovascular-issues","title":{"rendered":"A Change Of Heart: Research Reveals New Ways To Prevent Cardiovascular Issues"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-4800\" src=\"https:\/\/www.quinessence.com\/blog\/wp-content\/uploads\/2019\/09\/heart-issues.jpg\" alt=\"Tip for a healthy heart\" width=\"300\" height=\"200\" \/>Cardiovascular (CV) disease affects nearly half of all adult Americans<a title=\"\" href=\"#_edn1\" rel=\"nofollow\"><sup>[i]<\/sup><\/a> and is the leading cause of death in the U.S.<\/p>\n<p>Although it constitutes one of the most significant challenges facing the medical community, confusion remains around which therapies are best to manage the disease and prevent heart attack, stroke and death.<\/p>\n<p>For the 48% of adults in the U.S. with heart disease,<sup><a href=\"1035098#_edn1\" rel=\"nofollow\">[i]<\/a><\/sup> the American College of Cardiology (ACC) and American Heart Association (AHA) continue to recommend statins for at-risk patients. However, doctors are prescribing statins alongside drugs that the latest research shows may not work.<\/p>\n<p><strong>Two Steps Forward, One Step Back<\/strong><\/p>\n<p>Doctors began prescribing extended release niacin in the 1950s and fenofibrates in the 1970s, first in France and then eventually in the U.S., to help patients with heart disease lower their cholesterol.<sup><a title=\"\" href=\"#_edn2\" rel=\"nofollow\">[ii]<\/a>,<a title=\"\" href=\"#_edn3\" rel=\"nofollow\">[iii]<\/a><\/sup> Then, statins were approved in the late 1980s to help prevent CV risks such as heart attack, stroke and death from heart disease.<sup><a title=\"\" href=\"#_edn4\" rel=\"nofollow\">[iv]<\/a> <\/sup>Since then, tens of millions of people have been prescribed statins, many in combination with extended release niacin or fenofibrates.<sup><a title=\"\" href=\"#_edn5\" rel=\"nofollow\">[v]<\/a><\/sup><\/p>\n<p>However, in just the last decade, studies have shown that extended release niacin and fenofibrates are not effective in reducing the risk of cardiac events, such as a heart attack or stroke, even in combination with a statin.<sup><a title=\"\" href=\"#_edn6\" rel=\"nofollow\">[vi]<\/a>,<a title=\"\" href=\"#_edn7\" rel=\"nofollow\">[vii]<\/a><\/sup> For example, in a randomized, placebo-controlled Lipid Study of ACCORD (Action to Control Cardiovascular Risk in Diabetes), researchers found a lack of efficacy for what was then a blockbuster drug \u2014 fenofibrate \u2014 in patients with diabetes who were taking statins.<sup><a title=\"\" href=\"#_edn7\" rel=\"nofollow\">[vii]<\/a> <\/sup>The largest study of extended release niacin, which included more than 25,000 people with <a href=\"https:\/\/www.livescience.com\/34733-heart-disease-high-cholesterol-heart-surgery.html\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">heart disease<\/a>, was <a href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa1300955\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">published<\/a> in <em>The New England Journal of Medicine <\/em>showing a similar lack of efficacy.<sup><a href=\"1035098#_edn6\" rel=\"nofollow\">[vi]<\/a><\/sup><\/p>\n<p>As data and studies continued to emerge, they illustrated that the potential benefit of extended release niacin and fenofibrates no longer outweigh the potential health risks when taken with statins.<sup><a title=\"\" href=\"#_edn6\" rel=\"nofollow\">[vi]<\/a>,<a title=\"\" href=\"#_edn7\" rel=\"nofollow\">[vii]<\/a><\/sup> After this research was published, the Food and Drug Administration (FDA) took an unusual step in 2015 and withdrew its approval of extended release niacin and fenofibrates to treat cardiovascular disease in combination with statins.<sup><a title=\"\" href=\"#_edn8\" rel=\"nofollow\">[viii]<\/a><\/sup> Yet, in 2018, the total number of prescriptions for these drugs was almost 11.5 million and many are prescribed in combination with statins.<sup><a title=\"\" href=\"#_edn9\" rel=\"nofollow\">[ix]<\/a>,<a title=\"\" href=\"#_edn10\" rel=\"nofollow\">[x]<\/a> <\/sup>It is important for consumers to reconsider if they should still be on these drugs.<\/p>\n<p>\u201cStatins have been a great advancement in the cardiovascular space,\u201d said Norman Lepor, M.D., of Smidt\/Cedars-Sinai Heart Institute and Geffen School of Medicine at UCLA. \u201cBut for many people, they\u2019re not enough. Physicians, health care providers and patients should know that there are new scientific data regarding medications and treating cardiovascular risks, including elevated triglycerides and\/or diabetes, and those that further reduce LDL-cholesterol.\u201d<\/p>\n<p><strong>What You Can Do<\/strong><\/p>\n<p>Whether you have heart disease or not, playing an active role in and being aware of your health are critical for keeping your heart healthy. This includes diet, exercise, and consulting your doctor about new, proven options that can help reduce your risk of heart disease. The following questions, which you may want to discuss with your doctor, can help you take the first step in managing your heart health:<\/p>\n<ol>\n<li>What can I be doing to reduce my risk of heart disease?<\/li>\n<li>Is there new science available about the risks of heart disease?<\/li>\n<li>Is the treatment you\u2019re prescribing approved by the FDA for treatment of my specific condition?<\/li>\n<li>Is there a newer, potentially more effective treatment out there?<\/li>\n<li>If I\u2019m already using a statin, what is the best add-on for a holistic heart health treatment plan?<\/li>\n<li>If I\u2019m using more than one medication for my heart health, how do I know it\u2019s the most effective combination?<\/li>\n<\/ol>\n<p>Article Copyright \u00a9 BPT 2019  <img src='\/imagewriter?memberid=95643&#038;articleid=35074' border='0' width='1' height='1' \/><\/p>\n<p style=\"text-align: center;\">********************************************************************<\/p>\n<p style=\"text-align: left;\"><a title=\"\" href=\"#_ednref1\" rel=\"nofollow\">[i]<\/a> American Heart Association. Cardiovascular diseases affect nearly half of American adults, statistics show. January 31, 2019. Available at: <a href=\"https:\/\/www.heart.org\/en\/news\/2019\/01\/31\/cardiovascular-diseases-affect-nearly-half-of-american-adults-statistics-show\" rel=\"nofollow\">https:\/\/www.heart.org\/en\/news\/2019\/01\/31\/cardiovascular-diseases-affect-nearly-half-of-american-adults-statistics-show<\/a> (Accessed on February 22, 2019).<\/p>\n<div style=\"text-align: left;\">\n<p><a title=\"\" href=\"#_ednref2\" rel=\"nofollow\">[ii]<\/a> Ganji SH, Kamanna SV, Kashyap ML. Niacin and cholesterol: role in cardiovascular disease (review). Nutr Biochem. 2003 Jun;14(6):298-305.<\/p>\n<\/div>\n<div style=\"text-align: left;\">\n<p><a title=\"\" href=\"#_ednref3\" rel=\"nofollow\">[iii]<\/a> Lalloyer F, Staels B. Fibrates, glitazones, and peroxisome proliferator-activated receptors. Arterioscler Thromb Vasc Biol. 2010;30(5):894\u2013899. <a href=\"doi:10.1161\/ATVBAHA.108.179689.\" rel=\"nofollow\">doi:10.1161\/ATVBAHA.108.179689.<\/a><\/p>\n<\/div>\n<div style=\"text-align: left;\">\n<p><a title=\"\" href=\"#_ednref4\" rel=\"nofollow\">[iv]<\/a> Harrington RA. Statins-Almost 30 Years of Use in the United States and Still Not Quite There. JAMA Cardiol. 2017 Jan 1;2(1):66. doi: 10.1001\/jamacardio.2016.4709.<\/p>\n<\/div>\n<div style=\"text-align: left;\">\n<p><a title=\"\" href=\"#_ednref5\" rel=\"nofollow\">[v]<\/a> Salami JA, Warraich H, Valero-Elizondo J, et al. National Trends in Statin Use and Expenditures in the US Adult Population From 2002 to 2013: Insights From the Medical Expenditure Panel Survey. JAMA Cardiol. 2017;2(1):56\u201365. <a href=\"doi:10.1001\/jamacardio.2016.4700\" rel=\"nofollow\">doi:10.1001\/jamacardio.2016.4700<\/a><\/p>\n<\/div>\n<div style=\"text-align: left;\">\n<p><a title=\"\" href=\"#_ednref6\" rel=\"nofollow\">[vi]<\/a> Landray MJ, Haynes R, et al. Effects of Extended-Release Niacin with Laropiprant in High-Risk Patients. N Engl J Med 2014; 371:203-212.<\/p>\n<\/div>\n<div style=\"text-align: left;\">\n<p><a title=\"\" href=\"#_ednref7\" rel=\"nofollow\">[vii]<\/a> ACCORD Study Group, Ginsberg HN, Elam MB, Lovato LC, Crouse JR 3rd, Leiter LA, Linz P, Friedewald WT, Buse JB, Gerstein HC, Probstfield J, Grimm RH, Ismail-Beigi F, Bigger JT, Goff DC Jr, Cushman WC, Simons-Morton DG, Byington RP. Effects of combination lipid therapy in type 2 diabetes mellitus. N Engl J Med. 2010 Apr 29;362(17):1563-74.<\/p>\n<\/div>\n<div style=\"text-align: left;\">\n<p><a title=\"\" href=\"#_ednref8\" rel=\"nofollow\">[viii]<\/a> Food and Drug Administration. Withdrawal of approval of indications related to the coadministration with statins in applications for niacin extended-release tablets and fenofibric acid delayed-release capsules. 4\/18\/2016. Available via this link: <a href=\"https:\/\/s3.amazonaws.com\/public-inspection.federalregister.gov\/2016-08887.pdf\" rel=\"nofollow\">https:\/\/s3.amazonaws.com\/public-inspection.federalregister.gov\/2016-08887.pdf<\/a><\/p>\n<\/div>\n<div style=\"text-align: left;\">\n<p><a title=\"\" href=\"#_ednref9\" rel=\"nofollow\">[ix]<\/a> Fenofibrates annual sales report.<\/p>\n<p style=\"text-align: left;\"><a title=\"\" href=\"#_ednref10\" rel=\"nofollow\">[x]<\/a> Lovaza annual sales report.<\/p>\n<\/div>\n<div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>New research indicates there are newer, more effective ways to prevent cardiovascular issues . . .<\/p>\n","protected":false},"author":9,"featured_media":4800,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[491],"tags":[802],"class_list":["post-4798","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-research","tag-heart-health","Health Research"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.1 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>A Change Of Heart: Research Reveals New Ways To Prevent Cardiovascular Issues<\/title>\n<meta name=\"description\" content=\"New research indicates there are newer, more effective ways to prevent cardiovascular issues . . .\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, 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